When the heart ‘whispers’

Since we were so little, just a few weeks old in our mother’s womb, this particular organ has started it first beat and never to stop till the end of the time of its master. Since then, the beats get stronger and remain unnoticeable in the body; minding its own lifelong duty unless its master happened to be in a so-called emergency situation regardless of the cause. During these adrenaline-rush circumstances, the beats get so strong and quicken as if it announcing its presence us. The whole world knows this loyal organ as the HEART. Located strategically at the centre of the body, it is guarded with a strong but flexible rib cage and closed to the arms to be hugged in the time of need.
 
Not everyone has heard its repetitive, thumping yet powerful sounds simply because the heart sounds are only audible through auscultation. But do you know that the heart is also sometimes ‘whisper’ to the listener? However, this ‘whisper’ is nothing like that calming soft sound but the one that may cause nightmare to those with the ‘whispering’ heart.
picture taken from https://tenor.com/search/heart-gifs
The normal heart sounds are generated by the vibrations upon closure of the heart valves during its contraction. (1) The two distinct sounds are usually described as the lub-dub sounds of the heart. Sometimes, turbulent flow may occur within the heart; almost every time due to the abnormal condition of the heart. The turbulent generates a sound when the blood flows across the valves and this is what we called as murmurs; the ‘whisper’. These murmurs can be evaluated further by analyzing its timing in the cardiac cycle, the location, the duration, character, radiation, and many others. This information will assist the doctor to diagnose the probable heart condition. The most important aspect of the murmur which is the intensity will also help in diagnosing the severity of the heart condition. The intensity of murmurs is graded into 6 different grades, as follows:
 
Grade I • Heard in a quiet room by an 
Grade II • expert examiner – Heard by most examiners
Grade III • Loud murmur without the thrill
Grade IV • Loud murmur with a thrill
Grade V • Thrill with a very loud murmur audible with stethoscope placed lightly over the chest
Grade VI • Thrill with a very loud murmur audible even with the stethoscope slightly away from the chest
      **Thrill = palpable murmur
 
The grade of the murmur is important, as any murmur above grade II in severity warrants echocardiographic (scanning the heart) evaluation as per ACC/AHA guidelines.
Sometimes, the thrill of the murmur is described as same as touching the cat’s abdomen when they are purring. The presence of thrill will grade the murmur at least at grade IV.
 
All in all, when the heart is ‘whispering’, it normally indicates that it is sick. Discuss the management plan with your cardiologist and religiously follow the stipulated check-up. Love your heart and care for it.
 
Reference:
1. Ashvarya M & Saurabh. Heart Sounds from Medscape [updated 24 April 2014; Cited 31 January 2019]. Available from: https://emedicine.medscape.com/article/1894036-overview#a8
 
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